高压氧促进重度缺氧缺血性脑病新生儿智能康复的疗效观察

目的观察高压氧治疗重度新生儿缺氧缺血性脑病（HIE），促进患儿智能康复的近期、远期疗效。方法将同期住院的47例重度HIE患儿随机分为高压氰（HBO）组24例、对照组23例，两组接受相同的常规药物治疗至生后3个月，HBO组自生后8—10d开始接受HBO治疗，10d为1个疗程，每间隔10—15d进行下1个疗程，共4个疗程。两组患儿均按双盲原则，于生后7d、28d行新生儿行为神经（NBNA）测定，2岁时行Bayley婴幼儿发育量表（BSID）测试，于5岁时行韦氏学龄前儿童智力量表（WPPSI）测试，以评价HBO治疗重度HIE的近期与远期智能康复情况。结果HBO组28d时NBNA评分明显高于对照组（P〈0．01）；2岁时Bayley智力测定，HBO组心理发展指数（MDI）明显高于对照组（P〈0．05）；5岁时WPPSI智力测定，HBO组总智商（FIQ）和言语智商（VIQ）明屁高于对照组（P〈0．05）。HBO组智力缺陷发生率为12．5％（3／24），明显低于对照组39．1％（9／23）（P〈0．05）。结论HBO不仅可显著提高患儿的近期疗效，且能够明显改善患儿的远期预后，促进其智能康复，防治智力低下。

The effects of hyperbaric oxygen therapy on promotion of intellectual rehabilitation in infants with severe hypoxic-ischemic encephalopathy

Objective To explore the long-time effects of hyperbaric oxygen(HBO) therapy on the promotion of intellectual rehabilitation in infants with severe hypoxic-ischemic encephalopathy(HIE). Methods Forty-seven infants with severe HIE were randomly divided into a HBO group(n=24) and a control group(n=23). All the infants were treated with routine therapy for three months,in addition to HBO treatment in the HBO group once a day for four courses of 10 d with the interval of 10~15 d. Neonatal Behavioral Neurological Assessment (NBNA)assay was employed at 7 and 28 d after born,and Bayley Scale of Infant Development (BSID)assay was got at two years in two groups, as well as Wechsler Preschool and Primary Scale of Intelligence(WPPSI)assay at five years, in order to evaluated the short-time and long-time effects of HBO on intellectual rehabilitation in infants with HIE. Results Compared with that in the control group, the score of NBNA in the HBO group was significantly higher at 28 d(P<0.01) and the score of Mental Development Index (MDI)of BSID in the HBO group was significantly higher at two years(P<0.05), while the scores of Full-Scale Intelligence Quotient(FIQ) and Verbal Intelligence Quotient (VIQ) of WPPSI in the HBO group were significantly higher(P<0.05). In addition, the mental retardation rate(3/24) in the HBO group was significantly lower than that in the control group(9/23) (P<0.05). Conclusion Not only the short-time intellectual rehabilitation but also the long-time one in infants with severe HIE could be promoted by HBO therapy,which might be benefit to the prevention of mental retardation.